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To the Editor:

We read with great interest the article by Kawakami et al,1 who provided novel angiographic classification of chronic thromboembolic pulmonary hypertension (CTEPH) lesions and demonstrated that the outcome and complication rate of balloon pulmonary angioplasty (BPA) are mainly related to the location and morphology of treated thromboembolic lesions. First, we would like to congratulate the authors for their effort to analyze 1936 thromboembolic lesions assessed during 500 BPA sessions in 97 patients with CTEPH. However, despite this important novel angiographic classification, and its potential practical application, the authors concluded that during BPA …